Medical Surgical Nursing

(Tina Sui) #1

  • Blood volume increases leading to increased renal blood flow and diuresis

  • Body weight returns to normal
    -? Hypokalemia if no potassium replacement


Effects on blood volume



  • At the time of burn injury, some red blood cells may be destroyed and other damaged,


resulting in anemia



  • Despite this the hematocrit may be elevated due to plasma loss

  • Blood loss during surgical procedures, wound care, diagnostic studies and ongoing


hemolysis further contribute to anemia



  • Blood transfusions are required periodically to maintain adequate hemoglobin levels


for oxygen delivery



  • Abnormalities in coagulation, including a decrease in platelets (thrombocytopenia)


and prolonged clotting and prothrombin times occur with burn injury


Pulmonary Alterations



  • Inhalation injury is the leading cause of death in fire victims

  • Half of these deaths could have been prevented with use of a smoke detector

  • Burn victims make it out of a burning home safely

  • Once they are outside they may realize that loved ones or valuable items are still


inside the burning home



  • They then reenter the burning home and are overcome with toxic smoke and fumes
    and become disoriented or unconcious


Pulmonary response



  • Pulmonary imjuries fall into several categories, upper airway injury, inhalational


injury, including carbon monoxide poisining, and restrictive defects



  • Upper air way injury results from direct heat or edema

  • It is manifested by mechanical obstruction of the upper airway, including the pharynx


and larynx



  • Upper airway injury is treated by early nasotracheal or endotracheal intubation

  • Inhalation injury below the glottis results from inhaling products of incomplete


combustion (Burning) or noxious gases: carbon monoxide, sulfer oxide, nitrogen oxide,


& benzene

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